STOP Asthma

7^th May 2019 -the World Asthma day and the theme “STOP asthma”. Many children are suffering from asthma due to myths and doubts. Here we have answers for frequently asked questions

Many parents of children suffering from asthma end up with poorly controlled asthma due to myths and many doubts are often not addressed in office management in clinics due to lack of time. We can address some of the issues which are frequently asked questions by many parents and we shall address a few of them.

The world Asthma day is celebrated on 7th May 2019 at VIMS — **World Astama Day at Vydehi campus**

The world Asthma day is celebrated on 7^th May 2019 and this year the theme is STOP for asthma. STOP means:

S – Symptom Evaluation
T – Test Response
O – Observe and Assess
P – Proceed to Adjust Treatment

Is it asthma?

Asthma is a disease of the airways in the lungs, wherein the airways become swollen, narrow and sensitive to irritants, which leads to recurrent attacks of cough, breathlessness, noisy breathing and chest discomfort. The number of cases have been on the considering the changes in lifestyle and environment. Diagnosis of asthma in children under age 5 can be challenging as the symptoms may indicate other conditions. With older children Pulmonary function tests that measures how well the lungs work can be done.

Why do the children suffer from Asthma?

Children who have inherited a genetic predisposition, and exposed to inducers in the environment develop inflammation of airways, the hallmark of asthma. The most common triggers of asthma in children is a cold apart from dust, pollen, smoke and other irritants including air pollutants.

Can we recognise if child is at more risk of Asthma?

A family history of allergy and asthma is a predominant risk factor. If one parent has been diagnosed with allergies or asthma, the risk of the child developing asthma is approximately 50%, while if both parents have been diagnosed allergies and or asthma the risk of the child developing asthma is 75%.

Which allergens to be avoided?

Indoor allergens

Black mold

Dust mites

Cat and dog dander

Smoke- tobacco, cooking

Outdoor allergens

Pollen

Smoke-Automobile exhaust

What foods to avoid in an asthmatic child?

Generally avoiding the food items calling them “cold” items, like some fruits are not advisable. Rarely a child can be allergic to certain foods, such as milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish, and food additives.

Does child need allergy testing?

In general, in day to day practice allergy testing does not add much to the lines of management.

Will an air cleaner help child’s asthma?

It is not as effective with smaller particles such as dust and pollen. A HEPA (high-efficiency particulate air) filter has been proven to be effective in decreasing pet dander.

Child becomes breathless after running. Should he avoid games?

Children who have exercise-induced asthma (EIA) develop asthma symptoms after activity such as running, swimming, or biking. The time varies from 5-20 minutes post exercise before symptoms appear. With the proper medications, kids with EIA can usually play sports without a problem. Control asthma not exercise.

What are relievers and controllers?

Controllers are medicines that reduce inflammation in asthma, that work by reducing the swelling in the airways. The most effective of them being steroids. These medicines help to reduce severity of asthma if taken regularly as instructed. However, they must be taken regularly, even if child is not wheezing. Relievers are airway openers by dilating the narrowed bronchi and provide rapid relief airways known as bronchodilators. They only relieve symptoms but not airway inflammation. We must use controllers for long term and relievers for short term, and not vice versa.

Should we use nebulisers or inhalers?

Meter dose inhalers with spacers are preferred over nebulisers. Buying nebulisers by parents to use them for just relief of symptoms, and not taking long term medications are not advisable.

What is a spacer and is it necessary to use a spacer?

A spacer is a chamber that attaches to the MDI and holds the burst of medication. This allows child to breathe the medication into his lungs at his own pace. Spacers are recommended in children due to increased drug delivery.

Why steroids?

Steroids are the most effective anti-inflammatory medicines. They are safe in mild to moderate doses which most asthmatics use. Inhaled steroids are the best way to manage infants with asthma. Depending on young child’s age, one may use inhaled asthma drugs via MDI with spacer. It may need a mask in younger children less than three years.

How to know if child’s asthma is controlled? Should child take asthma medications even though he/she is feeling better?

Children feel better with relievers and some duration of controller medication makes the parents feel that they are “cured”, while on the contrary, still there will be inflammation in the airways. The parents should follow instructions of the paediatrician and continue the controllers which will be slowly stepped down and finally stopped. They should not abruptly stop medications. In older children paediatricians advise pulmonary function tests before stopping controllers.

How should one talk to people at child’s school about asthma?

It’s important that your child’s teachers, coaches, and school nurses know about his or her asthma. Talk to doctor about the best way to handle these discussions. Make sure that child has an “asthma action plan” and the proper medication at school with detailed instructions that include the location of the medicine or permission for child to carry it. Ask child’s doctor to help personalize this plan based on child’s asthma and treatment.

What Are the Goals of Treating Child’s Asthma?

The goals of asthma treatment for child are:

Child should be able to-